Healthcare Provider Details
I. General information
NPI: 1841400363
Provider Name (Legal Business Name): MAREK DS ASSOCIATES LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
W1859 COUNTY HIGHWAY B
STONE LAKE WI
54876-8002
US
IV. Provider business mailing address
W1859 COUNTY HIGHWAY B
STONE LAKE WI
54876-8002
US
V. Phone/Fax
- Phone: 715-865-4910
- Fax:
- Phone: 715-865-4910
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835G0303X |
| Taxonomy | Geriatric Pharmacist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DONALD
MAREK
Title or Position: PRESIDENT
Credential:
Phone: 715-865-4910